Peptic (Gastric) Ulcers

A peptic ulcer is a condition when there is an open sore in the lining of the stomach or intestine. In many ways it is similar to a sore in the mouth. When the ulcer occurs in the stomach it is called a "gastric ulcer". When it occurs in the duodenum it is called a "duodenal ulcer."

An ulcer occurs when the lining of these organs is corroded by the acidic digestive juices which are secreted by the stomach cells.

Normally, glands in the stomach secrete acid and the enzyme pepsin (hence the name peptic ulcer) that help to break down of food in the digestive process. The stomach and duodenum meanwhile secrete mucus to protect them against harm from pepsin and gastric acid. In peptic ulcer disease the digestive tract's defensive mechanisms break down, often as a result of infection with the bacterium Helicobacter pylori.

CAUSES

Excess acid was considered the major cause of ulcer disease. Acid is still considered significant in ulcer formation, the leading cause of ulcer disease is currently believed to be infection of the stomach by a bacteria called "Helicobacter pyloridus" (H. pylori). Another major cause of ulcers is the chronic use of anti-inflammatory medications, commonly referred to as NSAIDs(nonsteroidal anti-inflammatory drugs), such as Ibuprofen also including aspirin.Cigarette smoking is also an important cause of ulcer formation and ulcer treatment failure.

SYMPTOMS

Upper abdominal burning or burning stomach pain or hunger pain one to three hours after meals and in the middle of the night. These pain symptoms are often promptly relieved by food or antacids.

CARE AND GUIDANCE

The goal of ulcer treatment is to relieve pain and to prevent ulcer complications, such as bleeding, obstruction, and perforation. The first step in treatment involves the reduction of risk factors (NSAIDs and cigarettes). The next step is medications. Antacids neutralize existing acid in the stomach but these can give just temprory relief. H2 blockers are effective in ulcer healing, they have limited role in eradicating H. pylori without antibiotics. Therefore, ulcers frequently return when H2 blockers are stopped. Generally, these drugs are well tolerated and have few side effects even with long term use.